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Meeting mental health needs with innovation and connection

23 March 2021 | Professor Peter Fonagy
Programme Director for Mental Health and Behaviour Change, Professor Peter Fonagy, reflects on how innovation can enable the shift to a needs based approach to NHS mental health services.

The pandemic and impact of lockdown has exacerbated existing mental health needs.  Anxiety and depression are rising in the community and young people are particularly badly affected with research showing that 18- 29 year olds expressed the lowest level of wellbeing during the first wave.

Now, more than ever, we must ensure people receive the appropriate support when and where it is needed to help prevent the mental health pandemic that many are predicting in the wake of COVID-19.

Central to UCLPartners’ mental health and behaviour change programme is the transition to a needs-based, multi-agency model. We believe this shift can improve and widen access to care and that a focus on needs can prevent people falling between the gaps of diagnoses and services at this critical time.  

Innovation is key

Innovation is key to the transition to a needs-based model and, as in many health areas, the pandemic has instigated an acceleration in the implementation of new technologies.

At the end of last year our Commercial & Innovation team held an event to consider the challenges faced by NHS mental health services and the potential solutions afforded by new technologies.

Key note speakers from MIND and NHS England highlighted the positive shift in public attitude towards mental health and the national commitment of £2.3 billion of funding per year to ensure a place for everyone in mental health services.

Innovation has an important role to play in harnessing these opportunities and empowering staff and patients to meet mental health needs

Local and national innovation

We have seen a number of examples of innovation in mental health services. Home grown innovations have been implemented in the community, such as the DIALOG + app,, which uses a solution focussed therapy approach integrated with patient e-records. Others are working with commercial partners to implement bespoke solutions, exemplified in  East London NHS Foundation trust’s partnership with SilverCloud Health to adapt the digital platform for use with people with complex needs during the pandemic.

In acute care, we are seeing innovation in supporting Mental Health Act assessments and in integrating crisis call management with patient records. Vision-based monitoring of inpatients has been implemented successfully in a partnership between Essex Partnership University NHS Foundation Trust and the SME Oxehealth, which has just become part of the NHS Innovation Accelerator.

By freeing up clincians’ time and sharing data more effectively, all these innovations are helping meet mental health needs.

Innovation has also happened at a national level. UCLPartners is a collaborator in the iTHRIVE programme which has been using digital innovations during COVID-19 pandemic to improve mental health services for children and young people. And as part the AHSN Network, UCLPartners has been helping to roll out the FREED programme nationally to provide early intervention for eating disorders. A recent review by the Commercial & Innovation team showed that many NHS mental health services have adopted virtual consultations and are in the process of evaluating their effectiveness.

Challenges and sustainability beyond COVID-19

Of course, there are challenges to innovation, some of which seem more inherent to the system than others. ‘Digital exclusion’ is a term at the forefront of many innovators’ minds and it must be addressed if a solution is truly going to help provide that ‘place for everyone’ within mental health services.

Thinking within a needs based framework, digital inclusion must be incorporated and must also consider engagement as well as access. Privacy and immediacy is important, both of which are built into an approach piloted by East London NHS Foundation trust  who are using dedicated telehealth pods in their centres for video consultations, overcoming barriers both to digital access and engagement. Whilst a digital inclusion project in Haringey commissioned by North Central London CCG is supporting vulnerable people to access digital services through providing locations, and training.

However, even if digital exclusion is overcome, patients may still need to see someone face-to-face and in a place away from where they live.  Those who are vulnerable and many young people will need a space that is apart from their digital and their family world. As such choice and blended approaches are central to a needs-based approach.

A continuing challenge lies within resources –  it is estimated that if every psychologist worked 50 hours a week they would still only meet 12% of the current demand. A clear solution is to train a new workforce, potentially on the boundary between formal and informal care. This type of training at scale would be costly but, by using a digital approach, this could be overcome and it would be fantastic to see this adopted more widely.

Connection and collaboration

At UCLPartners we are interested in connecting people to forge partnerships and share knowledge to enable wider adoption of evidence-based innovations. We will be launching a Mental Health Trust Innovation Collaborative which will bring together innovation and digital teams of the six mental health trusts within the UCLPartners area. Its aim is to speed assessment and adoption of innovation through needs definition, industry engagement, real world validations and the leveraging of external funding and relationships with NHS innovation and digital networks.

We are also planning to establish a community of practice in mental health, providing a space for our NHS partners to share insight and expertise in the areas of innovation and transformation. We hope the community will encourage sharing of knowledge and evidence based solutions, as well as spark insightful and valuable discussions.

The COVID pandemic has undoubtedly taken its toll on mental health and to ensure a thriving next generation we must bridge the potentially widening treatment gap. A needs based approach can do this but it will require openness to and adoption of innovative approaches. By taking the path of innovation to meet mental health needs we can help  ensure that we capitalise on the available funding and increased public awareness that together represent a step change in the field of mental health.

If you are interested in being involved in the community of practice, please take 5 minutes to complete this short survey so we can build this space in a way that is most useful and accessible to you. If you are working within mental health and have an interest in innovation, technology and transformation please get in touch to sign up to the community of practice.